Some limits of informed consent

TLDR

Informed consent is valued for supporting autonomy, yet autonomy has many conceptions and debates over generic versus specific consent fail to address deception and coercion concerns. The authors contend that informed consent should be taken seriously because it safeguards patients from deception and coercion, and that consent procedures ought to grant patients control over information and the ability to rescind. They conceptualize consent as an intransitive propositional attitude, making complete specificity impossible, and propose that procedures should allow patients to control information and rescind consent.

Abstract

Many accounts of informed consent in medical ethics claim that it is valuable because it supports individual autonomy. Unfortunately there are many distinct conceptions of individual autonomy, and their ethical importance varies. A better reason for taking informed consent seriously is that it provides assurance that patients and others are neither deceived nor coerced. Present debates about the relative importance of generic and specific consent (particularly in the use of human tissues for research and in secondary studies) do not address this issue squarely. Consent is a propositional attitude, so intransitive: complete, wholly specific consent is an illusion. Since the point of consent procedures is to limit deception and coercion, they should be designed to give patients and others control over the amount of information they receive and opportunity to rescind consent already given.